Individual provider Active NPI

Katherine Clemente, PTA

  • Physical Therapy Assistant
  • Saint Cloud, FL
National Provider Identifier
1396328902
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA31072 Issued in FL
Practice address
1361 E Irlo Bronson Memorial Hwy
Saint Cloud, FL 34771-5823
Phone
(813) 382-7081
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA31072 FL Primary

Addresses

Primary practice location

1361 E Irlo Bronson Memorial Hwy
Saint Cloud, FL 34771-5823

Mailing address

14515 Clarkson Dr
Orlando, FL 32828-6464
Phone (813) 382-7081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA31072FLMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1396328902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 CLARKSON DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286464",
            "telephone_number": "813-382-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 E IRLO BRONSON MEMORIAL HWY",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347715823",
            "telephone_number": "813-382-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA31072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.